HealthNewsReview.org Ratings Criteria and Explanation1. Adequately discusses costs.
We believe that, in an era when health care spending represents 16% of the US gross domestic product, a story is incomplete if it does not address the costs of an approach, and a comparison with existing alternatives. We also think journalists should explore whether insurers are likely to pay for it.
2. Quantifies benefits.
Stories should give some sense of the size of the potential benefits of the approach being discussed. Stories (and studies, for that matter) should also explain the benefits in absolute, not just relative, terms.
3. Adequately explains and quantifies potential harms.
Stories should give a complete picture of potential harms of an approach, and quantify those potential harms in absolute terms.
4. Compares the new idea with existing alternatives.
We expect that a story would put the new approach being discussed into the context of existing alternatives, with some discussion of the possible advantages or disadvantages of the new approach compared with existing alternatives.
5. Seeks out independent sources and discloses potential conflicts of interest.
We expect, just as the Association of Health Care Journalists does, that journalists should “recognize that most stories involve a degree of nuance and complexity that no single source could provide. To reflect only one perspective of only one source is not wise; [journalists should] be vigilant in selecting sources, asking about, weighing and disclosing relevant financial, advocacy, personal or other interests of those [they] interview as a routine part of story research and interviews”[4].
6. Avoids disease mongering.
This criterion is an attempt to help journalists avoid promulgating the medicalization of normal states of or variations in health (e.g., baldness, menstruation, short stature, etc.). We also try to educate journalists about surrogate endpoints and about how risk factors are not diseases. With this criterion, we also remind them not to exaggerate the prevalence or incidence of a condition.
7. Reviews the study methodology or the quality of the evidence.
The story should reflect an understanding that not all studies are equal. If a story does not point out some of the limitations of an observational study and does not caution about interpreting uncontrolled data, for example, we will judge it unsatisfactory.
8. Establishes the true novelty of the idea
Many “new” products or procedures are not really novel. The product reported may be the sixth new member of a well-established class of drugs. It may be a device that has only been judged to be substantially equivalent to other devices already on the market. Journalists should accurately reflect the novelty (or lack thereof) of “new” products or procedures.
9. Establishes the availability of the product or procedure.
Many stories report on products or procedures that are still in clinical trials. We expect journalists to explain whether something is only available via limited access in clinical trials, whether something is FDA approved, whether insurability limits availability, etc. Many news stories seem to treat FDA approval of an investigational drug as a fait accompli, making predictions about how the drug “could be” or “should be” approved and on the market within a given time frame. Such stories would be rated as unsatisfactory.
10. Appears not to rely solely or largely on a news release.
We expect, just as the Association of Health Care Journalists does, that journalists should “Preserve journalistic independence by avoiding the use of video news releases or the use of quotes from printed news releases; label and credit the source whenever a portion of a video or printed news release is used” [4]. We expect a journalist to use a news release for background information only, and to then seek independent experts to comment on a development.